Since our circular in respect of COVID-19 dated 5 February 2020 we have unfortunately witnessed increasing numbers and exponential growth of COVID-19 cases worldwide. More and more countries are taking necessary and far reaching measures by which all non-essential movements of people are restricted/prohibited. In order to avoid further spreading of the virus and to avoid an overload of health care systems
and medical facilities in countries across the globe it is of paramount importance that we all remain alert and vigilant and implement and
comply with the most recent advices and recommendations in respect of hygiene measures, precautionary measures and restricting or banning
travel. This accounts for both your land-based offices as well as on board of your vessels, if not already done.
EF Marine is monitoring the recommendations by the World Health Organization (WHO) and other experts. It is important to keep your crews
updated with the most recent recommendations in respect of hygiene and preventive measures which include more frequent cleaning and disinfection strategies on board of your vessels and limiting the number of on board and visitors from shore and their access to ships areas.
We wish everyone strength and the best of health in these difficult times and recommend you take note of the below:
DISEASE OUTBREAK PREPAREDNESS AND RESPONSE PLAN
It is highly recommended to develop a clear and written disease outbreak preparedness and response plan. In case you are unable to do this yourself please contact a medical service supplier to assist you. For the disease outbreak preparedness and response plan for your land-based offices we refer you to the guidance and instructions of your local authorities. For the disease outbreak preparedness and response plan for your vessels we advise that the plan should at least (but not limited to) cover the following topics:
- Stringent hygienic rules in respect of cleaning, disinfection and waste management on board of your vessel.
- Options for onboard treatment and medical equipment inventories.
- Management of close contacts.
- Identifying a suspected case of COVID-19.
- An isolation plan stipulating the locations where suspected cases can be emporarily individually isolated until disembarkation together with hygiene rules for the isolation room including the use of personal protective equipment, cleaning and disinfection procedures and waste management.
FURTHER RECOMMENDATIONS
Considering the international trade shipping is involved in, several medical experts, government agencies and stakeholders have over time
issued guidelines with the aim to support ship operators and crews in managing suspect COVID-19 cases on board of vessels. Below we have
listed the more/most important ones:
A. FINDING ACCURATE INFORMATION ON COVID-19
In the times of social media and fast online communication, fake news is unfortunately spreading rapidly and can lead to people treating the issue with the wrong measures. Official government website and the website of the World Health Organization (WHO) should be consulted and
considered as reliable source of information. Other website information should be taken with caution and doubled checked against official
sources.
B. WHAT ARE THE SYMPTOMS OF COVID-19?
Most common symptoms for COVID-19 are fever, tiredness and a dry cough. Some patients also develop aches and pains, nasal congestion, runny nose, sore throat or diarrhea. It can be difficult to dissociate these symptoms from the common flu or a cold. It is therefore important to treat all cases – even mild cases - with caution.
Some people become infected but do not develop any symptoms and do not feel unwell while others become seriously ill (respiratory distress).
From the current observations made, most of the patients affected with COVID-19 who have become seriously ill are above 70 years of age or have underlying conditions that make them more susceptible to develop a serious condition from the COVID-19.
C. KNOWN INCUBATION PERIOD OF COVID-19
Based on what is known to date, the incubation period might go up to 14 days. This means that someone who has visited an affected area or has been in close contact with someone sick with COVID-19 can take up to 14 days to show symptoms. From what is known, a person infected with COVID-19 that does not show symptoms can be contagious and therefore anyone who stays on board after having visited an affected area or been in close contact with someone sick without protection should self-isolate for a period of 14 days.
D. ISOLATION ON BOARD THE VESSEL
If it is determined that there is a suspected case of COVID-19 on board, isolate the patient immediately, in a predefined isolation ward, cabin, room or quarters, with the door closed.
Minimal contact should take place with the patient and only designated personnel should be allowed to enter the room where the patient is isolated.
The caretaker should protect him/herself from in turn contracting the virus in wearing protective gear such as a mask, gloves, goggles and an
overall. Once the caretaker has left the room, he/she should immediately disinfect all protective reusable gear and dispose of any garbage into a closed specifically designated bin.
Depending on the configuration of the vessel, in case no separate bathroom / lavatory is available, the facilities should be thoroughly
disinfected every time the patient has made use of it. Other crew members or passengers that were in close contact with the ill person should also be asked to keep distances from other crew on board, to adopt a strict hygiene and to self-isolate as much as possible.
Close contact can be working in the same area or share a cabin.
Due to the confined space on board of a vessel, it will unfortunately not be rare that most of the crew has been in close contact with the patient during the incubation period. It is therefore recommended that each crew self-monitors its health and report any issues once a suspected case is declared on board.
A log of the patient condition and treatment provided should be kept.
E. HOW TO TREAT COVID-19?
Unfortunately, no cure or specific vaccine is yet available. Usual cold and flu medicine available in the vessels’ pharmacy should be provided on a case by case and as necessary.
The patient should be monitored to make sure that his / her condition does not require emergency (respiratory) care.
Medical advice should be seek if the patient develops a breathing problem or feels very ill (for example a fever that cannot be brought down by usual medicines such as paracetamol). If the respiratory frequency is above 20 breath per minute when the person is resting, or if the person has a moderately to severely reduced general condition it might be necessary to provide hospital care. In case of doubt
the crew should contact medical services for advice.
F. MEDICAL SUPPLIES AND EQUIPMENT
To allow your crew to deal with a possible infection by COVID-19, necessary disinfection products such as hand gel and protective gown should be available on board. See also the International Chamber of Shipping’s “Guidance for Ship Operators for the Protection of the Health of Seafarers”.
G. CALLING A PORT WITH A SUSPECTED CASE ON BOARD
In the event of a suspected diagnosis of COVID-19 onboard, the master should report the event as soon as possible to the next port of call, to allow the competent authority at the port to arrange, depending on the situation, medical evacuation or special arrangements for disembarkation and hospitalization of the patient and laboratory diagnosis.
As soon as the patient has been removed from the ship, the cabin or quarters where the suspected case of COVID-19 was isolated and managed should be thoroughly cleaned and disinfected by staff using PPE and who are trained to clean surfaces contaminated with infectious
agents.
The port health authority will conduct a risk assessment and all contacts of the suspect case should be identified and follow the instructions of the public health authorities, until the laboratory results of the suspect case are available. If the laboratory examination of the suspect case is positive for COVID-19, then all close contacts are likely to be quarantined for 14 days according to instructions from the competent authorities.
USEFUL LINKS:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019
http://www.imo.org/en/MediaCentre/HotTopics/Pages/Coronavirus.aspx
QUESTIONS?
Should you have any questions following this information, please do not hesitate to contact us.
ABOUT EF MARINE
EF Marine provides Fixed Premium P&I solutions to Shipowners, Charterers and MultiModal operators.
EF Marine has a global client base and offices in Singapore and Rotterdam. EF Marine provides ‘AA-‘rated security from Swiss Re Corporate Solutions with limits up to USD 500m. Through our partnership with Swiss Re Corporate Solutions we provide our clients with first class security combined with EF Marine’s extensive knowledge of the P&I market.